DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213444

Evaluation of outcome of pregnancy in placenta accreta spectrum

Uma Veludandi, B. Aruna Suman, S. Nagamani, Medha Hothur

Abstract


Background: Aim of the study was to evaluate the outcome of pregnancy in placenta accrete spectrum in third trimester pregnancy at tertiary care centre

Methods: This hospital based retrospective study was carried out from 2017 to 2019.  The case records of all women identified as placenta accrete spectrum from the hospital registers were retrieved. A total of 166 patients with the diagnosis of placenta accrete spectrum were included in the study.

Results: The incidence of morbidly adherent placenta is 5 per 10,000 deliveries with mean age being 32.4±4.2 (23-39) years. and showed its relation with risk factors such as previous caesarean section (CS), placenta praevia and multiparity. The mean duration of MICU stay in placenta previa was 6.7±1.9 days (range 2-12 days). With complications in 18 cases of which urinary bladder injury (3%), infection (9%), PPH and coagulopathy (4.2%). The placenta was removed successfully in 141 while 25 cases had caesarean hysterectomy (2.4%). In total 166 cases 26 (16.8%) cases are intrauterine device (IUD) and still births. 5 (3%) cases are very low birth weight, 24 cases (14.5%) are low birth weight babies, 76 (45.8%) cases had neonatal intensive care unit (NICU) admissions followed by 10 (6%) cases with <5 APGAR score.

Conclusions: Placenta accreta spectrum can be identified antenatally with a high index of suspicion in the presence of known risk factors and proper radiological studies, allowing for planned attempts to avoid life-threatening haemorrhage and caesarean hysterectomy.


Keywords


Placenta accreta spectrum, Haemorrhage, Caesarean hysterectomy

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